No easy VA health fix

While any bipartisan effort to get something of significance done in Washington is welcomed news these days, particularly legislation meant to assist our military veterans, the plan announced to fix problems at VA hospitals and clinics across the country should be viewed as at best a first step.

Demand on the VA health care system is straining its ability to meet patient needs and causing intolerable waiting lists. While the problem is more acute in some areas than others, the pressures facing the system are systemic - too many veterans to care for and not enough resources to get the job done.

The case in point that got the attention of the Obama administration and Congress was the situation at the Phoenix VA. A sampling of veterans in that region found an average waiting time of 115 days to receive care. The Veterans Affairs Administration reports 18 veterans died while awaiting appointments, though a further review is necessary to determine if the failure to get VA care contributed to those deaths. Some were in a terminal condition and seeking end-of-life care. That they could not get even that is distressing.

Adding to the scandal is evidence that the Phoenix VA staff falsified records to gloss over the long waiting times for care.

Last week two senators on opposite ends of the political spectrum proposed legislation to help. Conservative Sen. John McCain, R-Ariz., and hard-left Sen. Bernie Sanders, an independent from Vermont, offered a bill that would give veterans a choice to seek private care if they face long waits or if they live more than 40 miles from a VA facility.

It would also establish 26 new VA health facilities in 18 states, while making it easier for the VA secretary to fire staff for poor performance.

Some of the measures are redundant. The Obama administration has already set a policy that those patients facing waits of more than 30 days can seek private hospital and clinic care. The Veterans Affairs Department has pledged to extend clinic hours in many locations and boost hiring at understaffed locations (easier said than done).

The Senate legislation would allocate $500 million. Given the scale of the situation, caused by an aging population of older veterans and new demands from the Iraq and Afghanistan war vets, that will hardly cut it. The VA provides 152 hospitals and medical centers, and more than 900 clinics and mental health centers. Last year the VA expended $4.8 billion caring for more than one million veterans. Yet, clearly, it is not nearly enough.

Adding to the strain is a shortage of primary care doctors and difficulty in hiring more due to relatively low pay. Every VA doctor is responsible for hundreds of patients.

As U.S. Sen. Richard Blumenthal noted in supporting the bill, "There's a desperate need for a complete and comprehensive overhaul."

There will be no easy fix, but fix it the nation must.

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